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论《伤寒论》"主之""与""宜""属""以"区别

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《伤寒论》方剂条后"主之""与""宜""以"等字词,在表达方剂使用方法及药物配伍关系上存在不同含义."属"为后人批注,不纳入讨论;"主之"对应主证主方,主方能应对主证中所有症状,临床加减化裁不在主证主方讨论范围内;"与"则提示医家注意疾病变化,示意在复杂条件下商榷使用方剂;"宜"乃"适宜""合适"之意,所对应条文与治疗法则有关,提示相同治法下的加减用药;"以"提示病情复杂,可用试探法进一步观察病情,从而确定病性、病位或病理,试探之方宜小而精,不可误用猛法伤及人体正气.
Study on the Differences Between"Zhu Zhi""Yu""Yi""Shu"and"Yi"in Treatise on Cold Damage Diseases
In Treatise on Cold Damage Diseases,the terms"Zhu Zhi"(主之),"Yu"(与),"Yi"(宜),and"Yi"(以)used after the formulas have different meanings and characteristics in expressing the methods of formula application and the compatibility relationships between drugs.The term"Shu"(属)is later annotation and is not included in this discussion."Zhu Zhi"corresponds to the chief in-dication and the primary formula which is able to address all the symptoms under the chief indication,and clinical modifications or addi-tions are not within the scope of the chief indication and primary formula discussion."Yu"indicates that the physician should pay atten-tion to changes in the disease,suggesting a careful consideration of the formula's use under complex conditions."Yi"(宜)conveys the meaning of"appropriate"or"suitable,"relating to the therapeutic principle discussed in the corresponding text,though clinical appli-cation still requires modification of the drugs."Yi"(以)suggests that the condition is complex,and that a tentative approach should be employed to further observe the disease condition,thereby determining the nature,location,or pathology of the disease.The formula used in such testing should be small and precise,avoiding the misuse of sharp methods that could harm the body's healthy qi.

"Zhu Zhi""Yu""Yi""Shu""Yi"Treatise on Cold Damage DiseasesZhang Zhongjing

封飞、肖郁婷、王明炯

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天津中医药大学,天津 301617

湖南中医药大学,湖南 长沙 410208

湖南航天医院,湖南 长沙 410205

"主之" "与" "宜" "属" "以" 《伤寒论》 张仲景

2024

河南中医
河南省中医药学会 河南中医学院

河南中医

影响因子:0.968
ISSN:1003-5028
年,卷(期):2024.44(9)